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Corticosteroid drugs — including cortisone, hydrocortisone and prednisone — are useful in treating many conditions, such as rashes, inflammatory bowel disease and asthma. But these drugs also carry a risk of various side effects. When prescribed in doses that exceed your body's usual levels, corticosteroids suppress inflammation.
This can reduce the signs and symptoms of inflammatory conditions, such as arthritis, asthma or skin rashes. Corticosteroids also suppress your immune system, which can help control conditions in which your immune system mistakenly attacks its own tissues.
Corticosteroid drugs are used to treat rheumatoid arthritis, inflammatory bowel disease IBDasthma, allergies and many other conditions. These drugs also help suppress the immune system in order to prevent organ rejection in transplant recipients. Corticosteroids also treat Addison's disease, a relatively rare condition where the adrenal glands aren't able to produce even the minimum amount of corticosteroid that the body needs.
Corticosteroids are administered in many different ways, depending on the condition being treated:. Corticosteroids carry a risk of side effects, some of which can cause serious health problems. When you know what side effects are possible, you can take steps to control their impact. Because oral corticosteroids affect your entire body instead of just a particular area, this route of administration is the most likely to cause significant side effects.
Side effects depend on the dose of medication you receive and may include:. When using an inhaled corticosteroid, some of the drug may deposit in your mouth and throat instead of making it to your lungs. This can cause:. If you gargle and rinse your mouth with water — don't swallow — after each puff on your corticosteroid inhaler, you may be able to avoid mouth and throat irritation. Some researchers have speculated that inhaled corticosteroid drugs may slow growth rates in children who use them for asthma.
Injected corticosteroids can cause temporary side effects near the site of the injection, including skin thinning, loss of color in the skin, and intense pain — also known as post-injection flare.
Other signs and symptoms may include facial flushing, insomnia and high blood sugar. Doctors usually limit corticosteroid injections to three or four a year, depending on each patient's situation.
Corticosteroids may cause a range of side effects. But they may also relieve the inflammation, pain and discomfort of many different diseases and conditions. Talk with your doctor to help you better understand the risks and benefits of corticosteroids and make informed choices about your health.
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Show references Ritter JM, et al. The pituitary and the adrenal cortex. Elsevier; Accessed Oct. Grennan D, et al. Steroid side effects. Saag KG, et al. Major side effects of systemic glucocorticoids. Major side effects of inhaled glucocorticoids. Roberts WN, et al. Joint aspiration or injection in adults: Complications. Nieman LK. Pharmacologic use of glucocorticoids.
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Problems with mood swings, memory. Corticosteroids can have many long-term risks and side effects, including high blood pressure, weight gain, trouble sleeping, acne. Elevated blood sugar. Steroid tablets taken for longer than 3 weeks can potentially cause: increased appetite – which can potentially lead to weight gain if you find. Occurrence is often associated with dose and duration of therapy; long-term effects include HPA suppression, Cushingoid appearance. Can I exercise if I have atopic dermatitis? Talk with your doctor to help you better understand the risks and benefits of corticosteroids and make informed choices about your health. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices.Types of medicine. Corticosteroids, often known as steroids, are an anti-inflammatory medicine prescribed for a wide range of conditions. They're a man-made version of hormones normally produced by the adrenal glands two small glands that sit on top of the kidneys.
Corticosteroids can also be used to replace certain hormones that are not being produced by the body naturally — for example, in people with Addison's disease. Corticosteroids will only be prescribed if the potential benefits of treatment outweigh the risks.
They will also be prescribed at the lowest effective dose for the shortest possible time. There aren't usually any severe side effects if you take steroid injections, a steroid inhaler, or a short course of steroid tablets.
However, prolonged treatment at high doses — particularly with steroid tablets — can cause problems in some people. If you have troublesome side effects after taking corticosteroids, don't stop taking your medication until your doctor says it's safe to do so, because of the possibility of these unpleasant withdrawal effects.
Your dose may need to be reduced slowly over a few weeks or months, and you may have to have tests to ensure that your adrenal glands are still working properly before stopping corticosteroids altogether, if you have been taking them for a long time. Read more about the side effects of corticosteroids. For most people, including pregnant or breastfeeding women, steroid inhalers and injections are safe.
However, they will still only be used if a doctor thinks the potential benefits outweigh the risks. As steroid tablets are more likely to cause side effects, there are some circumstances when they shouldn't be used or should only be used with caution. These circumstances include:. Read more about who can use corticosteroids and interactions of corticosteroids. Visit our self-help guide on accessing medicines if you have difficulty getting the medicines you need. For most people, steroid inhalers and steroid injections should not cause any troublesome side effects.
Steroid tablets are generally prescribed with more caution, as these can potentially cause more problems. Corticosteroid tablets are the most powerful type of steroid medication, because they can affect the whole body. They shouldn't be used if you have an ongoing widespread infection, because they could make it more severe. However, you should continue to take corticosteroids if you develop an infection while already being treated, unless advised otherwise.
They should also be used with caution in people with a health condition that could be made worse by taking oral corticosteroids, including:. In these situations, you will only be prescribed oral corticosteroids if the benefits of treatment clearly outweigh any potential risks. Most people can safely have corticosteroid injections, but they should be avoided or used with caution if you have an ongoing infection or a blood clotting disorder such as haemophilia.
There is generally no reason why someone shouldn't be able to use a steroid inhaler or steroid spray, but these should be used with caution in people with ongoing infections, such as tuberculosis TB. Corticosteroids are generally safe to use during pregnancy. However, they're not usually recommended unless the potential benefits outweigh the risks.
For example, steroid tablets may be recommended if you're pregnant and have severe asthma , because the risk to your baby from uncontrolled asthma is higher than from the medication. There is no evidence that using a steroid inhaler during pregnancy increases the risk of problems such as birth defects, so you can usually continue to use this as normal while you're pregnant.
If a woman needs to take steroid tablets while she is breastfeeding, a type called prednisolone is usually recommended, because it is thought to have the least chance of causing the baby any adverse effects. As a precaution, it's usually recommended that a breastfeeding mother waits three to four hours after taking a tablet before feeding her baby. Steroid injections, inhalers and sprays are not thought to pose a risk to babies being breastfed.
Corticosteroids can interact with other medicines, and the effects of either medicine can be altered as a result. There is less chance of this happening with steroid injections or sprays, although it can occasionally happen if they're used at high doses and for a long time. Some of the more common interactions are listed below, but this is not a complete list. If you want to check your medicines are safe to take with corticosteroids, ask your GP or pharmacist, or read the patient information leaflet that comes with your medicine.
Anticoagulant medicines are medications that make the blood less sticky. They are often prescribed to people with a history of blood clots or an increased risk of developing them. Combining corticosteroids with anticoagulant medicines can sometimes make anticoagulants less effective.
Alternatively, it can increase their blood-thinning effect, which can cause bleeding inside the digestive system. Anticonvulsants are medicines used to prevent seizures fits and are often used to treat epilepsy , but they can reduce the effectiveness of corticosteroids. Depending on how frequent and severe your seizures are and the condition the steroids are being used to treat, you may be advised to temporarily stop taking anticonvulsants.
Corticosteroids can decrease the effectiveness of medications used to treat diabetes. If you need to take both of these medications, your blood glucose levels will usually be checked more regularly and your dose of diabetes medication may need to be adjusted. Corticosteroids, including steroid inhalers, can sometimes interact with a type of medication known as protease inhibitors such as ritonavir used to treat HIV. The HIV medication may increase the level of corticosteroid in your body, which might increase your risk of experiencing side effects.
Some vaccinations contain a weakened form of the infection they are designed to protect against. These are known as live vaccines. Examples of live vaccines include:. As corticosteroids can weaken your immune system and make you more vulnerable to infection, you should avoid any live vaccine until at least three months after your course of corticosteroids has finished.
Non-steroidal anti-inflammatory drugs NSAIDs are a group of commonly used painkillers, such as ibuprofen , that are available over the counter at pharmacists. Combining NSAIDs and corticosteroids can increase your risk of developing stomach ulcers and internal bleeding. If you need to take both medications, you may be given an additional medication called a proton pump inhibitor PPI to reduce the risk of stomach ulcers.
Some of the main side effects are listed below, but this is not a complete list. To learn about all the possible side effects of your medication, read the patient information leaflet that comes with it. Inhaled steroids usually have few or no side effects if used at normal doses.
However, they can sometimes cause:. Rinsing your mouth out with water after using your medication can help to prevent oral thrush, and using a device called a spacer with your medication can help to prevent many of the other problems. There is also some evidence that steroid inhalers used by people with chronic obstructive pulmonary disease COPD can increase the risk of chest infections such as pneumonia.
Inhaled steroids at high doses can sometimes cause some of the more serious side effects that are more often linked with steroid tablets see below , but this is rare. Steroids that are injected into muscles and joints may cause some pain and swelling at the site of the injection. However, this should pass within a few days. Steroid injections can also cause muscle or tendon weakness, so you may be advised to rest the treated area for a few days after the injection. Other possible side effects can include infections, blushing, and thinning and lightening of the skin in the area where the injection is given.
Because of the risk of side effects, steroid injections are often only given at intervals of at least 6 weeks and a maximum of 3 injections into one area is usually recommended. Steroids that are injected into a blood vessel intravenous steroids may sometimes cause some of the more widespread side effects described below. Short, occasional courses of steroid tablets taken for no longer than three weeks are very unlikely to cause troublesome side effects.
Most side effects should improve if you're able to reduce your dosage or eventually stop taking the medication. You may have regular checks and tests for conditions such as diabetes, high blood pressure and glaucoma if you need to take steroid tablets on a long-term basis. Source: NHS 24 - Opens in new browser window. Last updated: 07 January Home Tests and treatments Medicines and medical aids Types of medicine Types of medicine. Corticosteroids See all parts of this guide Hide guide parts 1.
Introduction 2. Who can use them 3. Medicines that interact with them 4. Side effects. Introduction Corticosteroids, often known as steroids, are an anti-inflammatory medicine prescribed for a wide range of conditions. Corticosteroids are available in different forms, including: tablets oral steroids injections — which can be into blood vessels, joints or muscles inhalers — such as mouth or nasal sprays lotions, gels or creams topical steroids What are corticosteroids used for?
Corticosteroids are mainly used to reduce inflammation and suppress the immune system. They are used to treat conditions such as: asthma allergic rhinitis and hay fever urticaria hives atopic eczema chronic obstructive pulmonary disease COPD painful and inflamed joints, muscles and tendons lupus inflammatory bowel disease IBD — including Crohn's disease and ulcerative colitis giant cell arteritis and polymyalgia rheumatica multiple sclerosis MS Corticosteroids can also be used to replace certain hormones that are not being produced by the body naturally — for example, in people with Addison's disease.
Possible side effects Corticosteroids will only be prescribed if the potential benefits of treatment outweigh the risks. Potential side effects of long-term treatment include: increased appetite — potentially leading to weight gain acne thinned skin that bruises easily increased risk of infections mood changes, mood swings and depression diabetes high blood pressure osteoporosis weak and brittle bones withdrawal symptoms caused by suppression of the adrenal glands If you have troublesome side effects after taking corticosteroids, don't stop taking your medication until your doctor says it's safe to do so, because of the possibility of these unpleasant withdrawal effects.
Cautions and interactions For most people, including pregnant or breastfeeding women, steroid inhalers and injections are safe. Accessing medicines self-help guide Visit our self-help guide on accessing medicines if you have difficulty getting the medicines you need.
Who can use them For most people, steroid inhalers and steroid injections should not cause any troublesome side effects. Steroid tablets Corticosteroid tablets are the most powerful type of steroid medication, because they can affect the whole body.
Steroid tablets should be used with caution in people with: liver problems, such as liver disease — corticosteroids may not be broken down by the liver at a normal rate, leading to increased levels of the medication in the blood mental health or behavioural problems, such as depression or alcohol dependence — corticosteroids can have unpredictable effects on behaviour and mood wounds — oral corticosteroids can delay wound healing They should also be used with caution in people with a health condition that could be made worse by taking oral corticosteroids, including: heart failure a recent heart attack high blood pressure diabetes epilepsy glaucoma underactive thyroid gland osteoporosis obesity psychosis stomach ulcers In these situations, you will only be prescribed oral corticosteroids if the benefits of treatment clearly outweigh any potential risks.
Steroid injections Most people can safely have corticosteroid injections, but they should be avoided or used with caution if you have an ongoing infection or a blood clotting disorder such as haemophilia.
Steroid inhalers and sprays There is generally no reason why someone shouldn't be able to use a steroid inhaler or steroid spray, but these should be used with caution in people with ongoing infections, such as tuberculosis TB.
Pregnancy Corticosteroids are generally safe to use during pregnancy. Breastfeeding If a woman needs to take steroid tablets while she is breastfeeding, a type called prednisolone is usually recommended, because it is thought to have the least chance of causing the baby any adverse effects. Medicines that interact with them Corticosteroids can interact with other medicines, and the effects of either medicine can be altered as a result. Anticoagulant medicines Anticoagulant medicines are medications that make the blood less sticky.
Anticonvulsants Anticonvulsants are medicines used to prevent seizures fits and are often used to treat epilepsy , but they can reduce the effectiveness of corticosteroids. Diabetes medication Corticosteroids can decrease the effectiveness of medications used to treat diabetes. HIV medication Corticosteroids, including steroid inhalers, can sometimes interact with a type of medication known as protease inhibitors such as ritonavir used to treat HIV.
Live vaccines Some vaccinations contain a weakened form of the infection they are designed to protect against.
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